Corneal abrasion causes substantial eye pain but has a relatively benign course. Eye patching, a common treatment, is thought to be helpful because it prevents rubbing of the eyelid over the cornea. Occluding vision with a patch decreases the patient's ability to function and may actually cause increased discomfort, and there is a potential risk of severe anaerobic bacterial infection in patients who normally wear contact lenses. Studies have failed to demonstrate the efficacy of patching in the treatment of corneal abrasions. Le Sage and associates used a single-blind, prospective, controlled trial to assess the usefulness of eye patching in the management of corneal abrasions in the emergency department.
Adults with traumatic corneal abrasions without other eye pathology received topical erythromycin ointment alone or ointment with a double occlusive patch over the injured eye. Foreign bodies, if present, were first removed in both groups. Other treatments such as the addition of a mydriatic agent or an opioid analgesic were left to the treating clinician's discretion. All patients were reexamined daily until healing was complete. Single blinding was accomplished by having the patched patients remove their patches before visiting the examining physician. Patients also completed pain and discomfort rating scales at each visit.
Among the 163 participants who were followed by clinic visits or telephone interview, reduction of pain and discomfort did not differ between the patched and unpatched groups. The corneal healing times were similar as well.
The authors conclude that eye patching should not be used in treating corneal abrasions. Eye patching does not speed healing or pain reduction; it can result in loss of binocular vision and may interfere with the patient's ability to participate in routine activities. Pain and discomfort remain significant during the initial 24 hours of treatment, and more effective ways to relieve pain without complications need to be considered.